Long segment ileal transposition leads to early amelioration of glucose control in the diabetic obese Zucker rat

Jodok Matthias Grueneberger; Tobias Fritz; Cheng Zhou; Sebastian Meyer; Iwona Karcz-Socha; Tomasz Sawczyn; Dominica Stygar; Matthias Goos; Ulrich Theodor Hopt; Simon Küsters

doi:10.5114/wiitm.2011.32925

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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2/2013
vol. 8

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abstract:

Original paper

Long segment ileal transposition leads to early amelioration of glucose control in the diabetic obese Zucker rat

Jodok Matthias Grueneberger

,

Tobias Fritz

,

Cheng Zhou

,

Sebastian Meyer

,

Iwona Karcz-Socha

,

Tomasz Sawczyn

,

Dominica Stygar

,

Matthias Goos

,

Ulrich Theodor Hopt

,

Simon Küsters

Videosurgery Miniinv 2013; 8 (2): 130-138

DOI: https://doi.org/10.5114/wiitm.2011.32925

Online publish date: 2013/01/21

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Introduction: Fast delivery of food to the terminal ileum is thought to be pathophysiologically responsible for type 2 diabetes remission after obesity surgery. Imitating this effect, ileal transposition (IT) is designed as initiating diabetes remission for non-obese patients.

Aim: To date, it is not clear which length of the transposed segment achieves the best glucose lowering results. As previous rodent data mostly rely on a 10 cm IT, the current study evaluated a long segment IT (20 cm) in the diabetic obese Zucker rat.

Material and methods: Twenty male diabetic obese Zucker rats (Crl:ZUC-Leprfa) were randomly assigned to undergo either a long segment (20 cm; ~ 50% of ileum) IT or sham surgery. Glucose control was determined by an oral glucose tolerance test (OGTT) on day –7, 0, 14 and 20. Analysis of the incretin hormones glucagon-like peptide 1 (GLP-1), peptide YY (PYY) and insulin was included in the first and third OGTT.

Results: Ileal transposition animals showed an early improvement of glucose control after 14 days (area under the curve: IT vs. baseline 314.7 ±229.0 mmol/l × min vs. 564.6 ±268.5 mmol/l × min; p < 0.05). Compared to sham animals, glucose-stimulated GLP-1 and PYY levels were raised (5.75 ±3.73 pmol/l vs. 18.52 ±14.22 pmol/l, p < 0.05; 129.7 ±64.62 pmol/l vs. 164.0 ±62.26 pmol/l, p < 0.05). Body weight gain from postoperative day 5 was greater for sham animals (50.22 ±20.93 γ vs. 16.4 ±25.93 g; p < 0.01).

Conclusions: Long segment IT shows a rapid rise in GLP-1 and PYY levels, thus leading to early amelioration of glucose control.

keywords:

Long segment ileal transposition leads to early amelioration of glucose control in the diabetic obese Zucker rat

Jodok Matthias Grueneberger , Tobias Fritz , Cheng Zhou , Sebastian Meyer , Iwona Karcz-Socha , Tomasz Sawczyn , Dominica Stygar , Matthias Goos , Ulrich Theodor Hopt , Simon Küsters

ileal transposition, ileal transposition, type 2 diabetes mellitus, obesity surgery, metabolic surgery

Jodok Matthias Grueneberger

,

Tobias Fritz

,

Cheng Zhou

,

Sebastian Meyer

,

Iwona Karcz-Socha

,

Tomasz Sawczyn

,

Dominica Stygar

,

Matthias Goos

,

Ulrich Theodor Hopt

,

Simon Küsters